I am Forbes' Opinion Editor. I am a Senior Fellow at the Manhattan Institute for Policy Research, and the author of How Medicaid Fails the Poor (Encounter, 2013). In 2012, I served as a health care policy advisor to Mitt Romney. To contact me, click here. To receive a weekly e-mail digest of articles from The Apothecary, sign up here, or you can subscribe to The Apothecary’s RSS feed or my Twitter feed. In addition to my Forbes blog, I write on health care, fiscal matters, finance, and other policy issues for National Review. My work has also appeared in National Affairs, USA Today, The Atlantic, and other publications. I've appeared on television, including on MSNBC, CNBC, HBO, Fox News, and Fox Business. For an archive of my writing prior to February 2011, please visit avikroy.org. Professionally, I'm the founder of Roy Healthcare Research, an investment and policy research firm. In this role, I serve as a paid advisor to health care investors and industry stakeholders. Previously, I worked as an analyst and portfolio manager at J.P. Morgan, Bain Capital, and other firms.

I’ll get to President Obama’s unremarkable State of the Union address in a moment. But first I want to discuss the first major televised address of the man who very well may be the next President of the United States: Sen. Marco Rubio of Florida. Sen. Rubio forthrightly addressed in both English and Spanish the principal domestic challenge of our time—the health care-driven budget deficit—while President Obama dishonestly insisted that Medicare reform was being held hostage by “special interest tax breaks.”

“Obamacare,” said Rubio, “was supposed to help middle class Americans afford health insurance. But now, some people are losing the health insurance they were happy with. And because Obamacare created expensive requirements for companies with more than 50 employees, now many of these businesses aren’t hiring. Not only that: they’re being forced to lay people off and switch from full-time employees to part-time workers.”

In that one paragraph, Sen. Rubio captured the fundamental flaw in the so-called Affordable Care Act: it makes health insurance more expensive, in turn making hiring more expensive, and our health-care entitlements more expensive. But what Rubio did better than any recent GOP respondent to the President’s State of the Union address is to express, in relatable language that appealed to people who don’t already vote Republican.

“The biggest obstacles to balancing the budget,” he continued, “are programs where spending is already locked in. One of these programs, Medicare, is especially important to me. It provided my father the care he needed to battle cancer and ultimately die with dignity. And it pays for the care my mother receives now. I would never support any changes to Medicare that would hurt seniors like my mother. But anyone who is in favor of leaving Medicare exactly the way it is right now, is in favor of bankrupting it.”

“Republicans have offered a detailed and credible plan that helps save Medicare without hurting today’s retirees. Instead of playing politics with Medicare, when is the President going to offer his plan to save it? Tonight would have been a good time for him to do it.”

Obamacare expanded health-care entitlements

In fairness to the President, he did sign into law $716 billion in Medicare cuts over the next ten years—but he’s using those cuts to partially fund $1.9 trillion in additional health spending for others over the same period. And liberal wags on Twitter argued last night that Rubio’s successful performance was more an indictment of the previous SOTU respondents than a statement of Rubio’s eloquence.

I don’t agree. Paul Ryan and Mitch Daniels, in particular, effectively critiqued the President’s policies in their SOTU responses. But Rubio went a step further, largely because he could speak so persuasively of his own journey as the son of immigrants in a middle-class Miami neighborhood.

President Obama, for his part, agreed that “the biggest driver of our long-term debt is the rising cost of health care for an aging population. And those of us who care deeply about programs like Medicare must embrace the need for modest reforms—otherwise, our retirement programs will crowd out the investments we need for our children, and jeopardize the promise of a secure retirement for future generations. But we can’t ask senior citizens and working families to shoulder the entire burden of deficit reduction while asking nothing more from the wealthiest and more powerful.”

But here’s the rub: For President Obama, “asking something from the wealthiest” translates into raising taxes on economically productive businesses, instead of reducing federal spending on the wealthy. If we gradually raised the Medicare eligibility age, for example, the net effect would be to prevent taxpayers from subsidizing the health care of wealthy retirees, because the means-tested exchanges would gradually replace the universal Medicare program.

But Obama is enamored of the opposite approach: raising taxes and hurting economic growth, so as to ensure that the federal government can continue to support health spending on people who don’t need the government’s help. Obama once again brought up the canard about Warren Buffett’s secretary having a lower tax rate than Warren Buffett, but he was silent on the question of why a secretary pays taxes to fund Buffett’s health coverage.

If you think I’m putting words into the President’s mouth, yesterday, his press secretary, Jay Carney, said that Obama “has made clear that we don’t believe that that’s the right policy to take.” Obama supported raising the retirement age in concert with tax hikes, but not as a replacement for cuts to discretionary federal spending.

For the next two years, President Obama’s main goal is to help Democrats retake the House of Representatives, so that the remainder of his term can be devoted to a broad range of progressive policy objectives. Republicans will only be able to withstand Democrats’ barrage with sound policy and an effective spokesman. In Marco Rubio, they clearly have the spokesman.

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Its a matter of time before a computer complete automates the writer’s position…then we will see him blogging on a GOP controlled internet that has corp;orate America editing his posts and making him out to be a terrorist! See, its amazing who is against whom in this race. The most ironic thing that Rubio said last night was about his childhood. He said that his parents had opportunities…YEAH, OF COURSE. The problem is, the very opportunities that his parents had ARE GONE because of GOP policies! Dems are trying to find a way to offset the massive atrocities that the GOP has inflicted over the past 45 years by making sure that they ones they crushed with debts are able to take their slave wages and actually eat, clothe children, etc.. When you give all the pawns on the board up first, there is nobody left to defend the Kings and this was the folly of the GOP and rich financial backers plans. And when this happens, the managers start falling too. How long before Corporate “Murica” realizes that 1 American manager making $200K/yr, a 401K, Profit Sharing, Paid Vacation and Sick Days, Mandatory health insurance, working 8 hours a day etc. is not easily replaced by 3 SMARTER and HARDER working Chinese Managers for $120K/yr, no insurance, no vacations, no profit sharing, no sick days, and get 24hrs a day/7 days a week of production out of them? This is the situation we are ALL facing as a nation. The solution. STOP SUPPORTING ANY Multinational corporation by cutting off their funds. Pay more to shop locally and kill the large businesses that dont care about anything except staying on top while crushing their own employees and stakeholders to be there. Rubio does not see, identify with or have a solution to his “Big Government” problem that is really a Big Corporation problem. Nobody does…

Clearly you can’t be a writer for Forbes and be allowed to sidestep at least one blatant and obvious truth…Your very first comments are BS! If you start with BS, you leave with BS and unfortunately this is what your article has accomplished. The comments about, and I re-quote: “expensive requirements for companies with more than 50 employees, now many of these businesses aren’t hiring. Not only that: they’re being forced to lay people off and switch from full-time employees to part-time workers” is completely inaccurate. It’s easy to lie for the sake of effect. Businesses are going to sidestep and work the system to weasel themselves from higher costs and any interest in supporting their employees through only hiring part time workers. PLEASE! This is completely in line with what Mr. Obama continues to state regarding how big business only wants to remain BIG at the cost to ANYONE else (there are actually some kind hearted selfless companies in our world). Your argument is weak and I’m shocked posted under the name FORBES. Something needs to be done but lies about the sorry state of anything/one will soon come to light. Start with light and the end result is light.

Avik, why do we have to start from scratch? How about we eliminate ALL, 100% mandated services from Obmacare, except that NO PERSON can be prevented from purchasing a CATASTROPHIC, HIGH DEDUCTIBLE HSA Plan from the for-profit insurer of their choice? Is that still tyranny? If not, why do we have to start from scratch? Of course, I know the answer. Unless we do kill ObamaCare and start from scratch ObamaCare and the DEMs will get credit for WINNING(I LOVE POLITICS AND SPORTS: JUST WIN BABY…AND SPIKE THAT FOOTBALL…ALL I CARE ABOUT IS WINNING!!! ) the health care war for of the last 40 years and will be able to use that against the GOP in every election for a generation.

How can you call yourself a journalist and defend all the lies Senator Rubio told both about the Affordable Health Care Act and how government caused the housing crisis. And barely spoke about the immigration. His speech wasn’t even a response on the State of the Union as it was a criticism of our president. He does not represent the Cuban community and more and more of us Cuban Americans will be voting democratic next election!